Body or soul?

Psychotropic medications are a sensitive topic; most people you talk to will have fairly strong opinions about whether or not they should be used in treating a host of life’s problems. In thinking about this, though, it’s helpful to take a step back and consider who we are as human persons. In doing so, this helps us understand where life issues fall on the spectrum between spiritual problems and physical problems. Once we understand where a particular issue falls on that spectrum, we can better assess the place that psychotropic medication may have for a given counselee.

Avoiding extremes

Both Christian counselors and secular counselors tend to run in one direction or the other when it comes to life struggles as spiritual problems or physical problems. Let’s take the issue of addiction, for example. If it’s a spiritual problem, then sometimes the naïve approach becomes finding the root of the sin and shooting it with the Bible bullet, getting to repentance and assuming everything will be fine. On the other side, though, if it’s a physical problem, then we’ll send them to a doctor to get the medication or treatment that they need.

However, both of those approaches leapfrog over the actual person. They miss getting to know the person, getting a sense of his experience, where the person is, and what’s really going on with him. These approaches miss getting a personal history and understanding the person’s circumstances. And they fail to understand the problem thoroughly.

The other concern with running in either direction, for instance, toward addiction as solely a spiritual problem or as solely a physical problem, is that they miss the complexity of the human being. Every person we minister to is both a spiritual being and a physical being. Every person is a body and a soul. So there’s always going to be both parts of human persons that we need to understand, and both parts of them matter in understanding their problem. When we reduce their problems down to either spiritual or physical, rather than spiritual and physical, we miss out on understanding them and their problems completely.

Every person we minister to is both a spiritual being and a physical being, and both parts matter in understanding the problem.

Discerning between spiritual and physical

When it comes to differentiating between what is physically broken and what is morally wrong, much of this seems to be related either to physical brokenness or some type of medical or physiological problem, or to some sort of moral, spiritual problem the person may have. To start, though, there are some issues that Scripture specifically addresses or specifically forbids, or provides guidelines or directions for. In those cases, we can say that it is clearly a spiritual, moral issue. There may be a biological component, but if Scripture addresses the issue directly, then we’re going to have to address it directly and bring God’s Word to the person.

A good example of this is individuals who have been diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). They sit through sermons at church or lectures in a classroom, and they can tune in for about the first five minutes and that’s it. They have a really difficult time paying attention for an extended period of time. As I think about that problem, I think about how Scripture speaks to it. The Bible doesn’t say “thou shalt not be distracted” or “thou shalt always pay attention.”

On the other hand, a person with ADHD oftentimes can be very impulsive. So perhaps this person is constantly interrupting other people during discussions. Those interruptions may be connected to his inattentiveness, but interrupting others really isn’t a loving thing to do. And we are commanded all over in Scripture to love our neighbor, to be considerate and understanding of others. So interrupting people clearly has a spiritual, moral dimension.

When we think about these sorts of issues, and others that we often encounter in counseling, there’s a spectrum that we can place given behaviors on where they seem to be more physiological, somatic, or clearly medical issues. And then on the other end of that spectrum, there’s more spiritual and moral issues. But I don’t think anything ever completely fits at one end of the spectrum or the other. We’re always both spiritual and physical beings. Because of this, then, we have to understand that life struggles involve both the spiritual and physical parts of the person.

Avoiding extremes with psychotropic medications

As I noted above, psychotropic medications are a sensitive topic; people have strong opinions about using them. But we have to counsel out of biblical wisdom rather than personal opinion. I think counseling that is properly biblical is not about imposing one’s personal opinion on other people, and it’s also not about adding to Scripture.

But in this conversation about psychotropic medications, we see one extreme of “thou shalt not take Prozac” on one end, and on the other end, the idea that every emotional problem is a brain neurotransmitter problem. Proponents believe that people must take medicine in order to be properly cared for. The “blame it on the brain” mentality in this extreme isn’t biblical because we’re also spiritual beings with moral responsibility. But the “thou shalt not take Prozac” extreme ignores the reality of a physical body. Either of these extremes neglects the complexity of human beings as always body and always soul.

Our role as pastors and counselors is to help people discern what might be wise for them and whether or not a referral for evaluation for medication might be warranted. We must remember that this is all a pastor or counselor ever does. We aren’t prescribing or non-prescribing, or saying yes or no to medication. This right belongs to the counselee and his physician. Our job is simply to assess whether or not it’s warranted to refer that person to a competent physician for evaluation. We may pray with the counselee and discuss the possibility of seeing the physician, but we must avoid imposing our own opinions on him.

To conclude, giving counsel about psychotropic medications isn’t simply about what a person’s struggle is, whether it be an addiction, ADHD, or any of a host of other mental disorders. What it is about is the human person, who exists as both body and soul, and who also experiences life struggles as both physical and spiritual. As pastors and counselors, we exercise much wisdom in caring for both body and soul, rather than neglecting one or the other.

Editor’s note: For other resources on this topic, take a look at Can Your Church Help the Mentally Ill? Here Dr. Williams and other experienced counselors and pastors help navigate this topic of mental illness and psychotropic medications. Also, see Pastor, Should I Take Psychiatric Meds? In this article, Brad Hambrick gives pastors a step-by-step guide for making decisions about psychiatric medications.

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Sam R. Williams, PhD, is professor of counseling at Southeastern Baptist Theological Seminary in Wake Forest, NC, where he has taught for the last fifteen years. He was in private practice for ten years as a licensed clinical psychologist and has been counseling for thirty-five years. He loves his wife, Mindy, his three sons and daughter, his church North Wake, and Brazil. He tolerates and funds his wife’s four cats.

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